Library

[Liu Wansu (courtesy name Shouzhen, pseudonym Hejian Jushi, known as Liu Hejian)] A woman had a cold body and a faint pulse. She consumed boiling hot porridge and rice, wore heavy clothes in June, covered her head with a hat and scarf, yet still felt cold. She suffered from incessant watery diarrhea. She had long taken drying and heating agents such as ginger, Aconite (Fuzi), and sulfur, achieving only temporary mildness; whenever slightly cooling medicines were used, her condition worsened. This persisted for three years without cure. Dairen (Zhang Congzheng, courtesy name Zihe, pseudonym Dairen) examined her pulses on both hands, which felt like horizontal ropes and were forceful, beating six or seven times per breath cycle. The *Maijue* (Pulse Classic) states: "Six rapid beats indicate excessive heat." (Meaning: fast pulse rate indicates heat syndromes). Using cool cloth to compress the heart region, and splashing fresh well water on the affected areas, the woman screamed incessantly. People were instructed to repeatedly splash cold water on her until thirty or forty buckets were used. She then profusely sweated with chills, remained drowsy and exhausted for one or two days, and all the previously disliked cold symptoms were eliminated. This method originated from Hua Tuo's practice, but was unknown to the world.

*[Suwen]* What Yangming refers to as "shivering with aversion to cold" occurs because Yangming corresponds to the Wu hour, representing Yin within the peak Yang of the fifth month. When Yang is at its peak and Yin qi acts upon it, shivering with aversion to cold results. (From *Maijie Pian*) This is the counter-treatment for upper jiao cold-excess, specifically referring to cases where the pulse is full and large yet there is aversion to cold. Full pulse with aversion to cold indicates false cold, hence the counter-treatment is applied.

[Zhu Zhenheng (courtesy name Yanxiu, pseudonym Danxi, known as Zhu Danxi)] For aversion to cold resulting from chronic illness, one should use methods to resolve stagnation. When damp-phlegm accumulates in the middle jiao, it suppresses and obstructs Yang qi, preventing it from venting outward, causing the body to feel cold.

The Jinshi Zhou Bendao, nearly forty years old, suffered from an aversion-to-cold syndrome. After taking hundreds of doses of Aconite (Fuzi), his condition worsened. I palpated his pulse, which was wiry and slow. I prescribed black tea mixed with a small amount of fresh ginger juice and sesame oil, inducing him to vomit approximately one liter of phlegm, reducing his symptoms by more than half. Subsequently, I administered *Tongsheng San* (Universal Rescue Powder) modified by removing Ephedrae Herba (Mahuang), Rhubarbi Radix et Rhizoma (Dahuang), and Mirabilits Sal (Mangxiao), adding Angelicae Sinensis Radix (Danggui) and Rehmanniae Radix (Dihuang). After one hundred doses, he recovered.

A young woman suffering from aversion to cold was treated with Coptidis Rhizoma (Kushen) and Adzuki Bean (Chixiaodou), each one qian, ground into powder. After gargling with vinegar water to induce vomiting, she took the following prescription:
Ligusticum Chuanxiong Rhizome (Chuanxiong), Pinelliae Rhizoma Preparatum (Nanxing), Atractylodis Macrocephalae Rhizoma (Cangzhu), Scutellariae Radix (Huangqin), made into pills with wine and flour.
When the upper jiao is blocked, Yang qi is suppressed, and the skin and muscle spaces fail to receive warmth, resulting in chills and trembling. Li Dongyuan's *Shengyang Yiwetang* (Raise Yang Tonify Stomach Decoction) uses ascending and dispersing agents to open the upper jiao, allowing Yangming Qi to emerge outward, thereby providing warmth. Danxi's induction of vomiting to expel damp-phlegm also opens the upper jiao, allowing Yang qi to ascend and emerge outward through vomiting, providing warmth. Thus, chills and trembling are cured. These two approaches are key treatments for deficiency of Yang with exterior cold.

In the theory of Six Qi (Yunqi), there are three types of aversion to cold:
First, Fire-Heat. The classics state: "All cases of inhibition, drumming, and tremors, resembling loss of spiritual control, belong to Fire." It also says: "When Shaoyang arrives, it manifests as aversion to cold and shaking." And again: "When Shaoyang is in the Earthly Position, if guest qi prevails, waist and abdominal pain occur with contrary aversion to cold." Treatment involves cold-natured agents.
Second, Wind. The classics say: "When Jueyin is in the Earthly Position, if Wind pathogen prevails, the disease manifests as shivering with aversion to cold." Treatment involves acrid-cool agents.
Third, Cold-Damp enveloping Heat. The classics state: "When Yangming governs the Heavenly Position, the clearing-heat qi persists at the intersection of qi, and the people suffer from shivering and aversion to cold. In the fourth qi period, when cold rain descends, the disease manifests as shivering and trembling." Treatment depends on the severity of cold and heat, adjusting the proportions of the formula accordingly.

*[Lingshu]* Yin and Yang correspond to cold and heat. In heat, rain nourishes above, roots lack juice, human qi is external, skin is relaxed, pores are open, blood and qi decrease, sweat flows heavily, and skin becomes moist and glossy. In cold, the ground freezes and water turns to ice, human qi is internal, skin is dense, pores are closed, sweat does not exit, blood and qi are strong, and muscles are firm and stiff. At this time, those skilled in moving water cannot go to ice, and those skilled in digging earth cannot pierce frozen soil. Those skilled in acupuncture also cannot treat four extremities reversal (Jue). When blood vessels are coagulated and hard, resisting flow, they cannot be immediately softened. Therefore, those who move water must wait for warm weather, when ice melts and frost dissolves, so that water can flow and earth can be penetrated. Human meridians are similar. To treat Jue (reversal/cold limbs), one must first apply moxibustion compression (Wen) to harmonize the meridians, treating the palms and axillae, elbows and feet, neck and spine. Once fire qi has circulated and blood vessels are flowing, one then examines the condition. If the pulse is soft and glossy, puncture to level it. If hard and tight, break and disperse it. Stop when qi descends. This is called untying knots. (From *Cijie Zhenxie Pian*, same below) The essence of acupuncture lies in regulating Qi. Qi accumulates in the stomach to circulate Ying and Wei, each following its own path. Zong Qi (Gathering Qi) remains in the Sea of Qi (Dan Zhong); its lower part pours into the Qichai (Stomach meridian point ST30), and its upper part travels to the respiratory tract. Therefore, if Jue is in the feet, Zong Qi fails to descend, blood in the vessels coagulates and stops. Without fire therapy regulation, it cannot be treated. Acupuncturists must first observe the excess or deficiency of meridians, palpate and follow them, press and flick them, observing where there is a reactive movement, then select points and reduce. When the six meridians are harmonious, it is called no disease; even if diseased, it will self-heal.

Great cold remaining externally requires tonification. Pathogens entering internally require reduction via He-Sea points. Where acupuncture is ineffective, moxibustion is suitable. (From *Gonneng Pian*, treat via He-Sea points.)

Yellow Emperor asked: "What causes shivering and aversion to cold?" Qibo answered: "Cold pathogen lodges in the skin, Yin qi is abundant, Yang qi is deficient, thus causing shivering and cold tremors. Tonify the Yang meridians."

Regarding acupuncture for organ-related aversion to cold, there are three types:
First, take Lung-related points. The classics say: "Shivering, jaw quivering, inability to sweat, abdominal distension with vexation, take Hand-Taiyang points." Second, take Stomach points. The classics say: "The Foot-Yangming Stomach Meridian, when moved, causes shivering with aversion to cold, frequent stretching and yawning. Observe excess/deficiency, heat/cold, and sinking; treat accordingly." Third, take Gallbladder points. The classics say: "The Foot-Shaoyang Gallbladder Meridian, diseases arising from it include sweating with shivering and aversion to cold. Observe excess/deficiency, heat/cold, and sinking; treat accordingly."

*[Zhenjiu Dacheng]* Coldness in the lower part: Guanyuan (CV4), Shenshu (BL23).

[Sang Jun] Another method: Qihai (CV6), Zhongji (CV3).

*[Jiayi Jing]* Shivering with spasms, inability to extend hands, coughing with turbid sputum, chest diaphragm obstruction with frequent vomiting, jaw quivering without sweat, vexation with whole-body pain, due to spasms: primarily treated with Chize (LU5).
Head and neck aversion to wind, no sweat, chilling with cold limbs and aversion to cold, vomiting, tension of eye connections, pain radiating to forehead, heavy head and painful neck: primarily treated with Yuzhen (GB9). Chilling shivering with frequent yawning and stretching: primarily treated with Geshu (BL17).

*[Mi Yu]* Whole-body aversion to cold, tendon and vessel constraint, ten fingers unable to tolerate wind: Jiexu (GB39) (located 2.5 cun above the tip of the lateral malleolus. Push upwards until Qi feels balanced for relief).